At some tipping point, this becomes the new trajectory of your life. Life’s challenges continue to come at all of us. As life becomes easier to navigate, your body is exposed to less threat (stress) physiology and more to safety. Safety is where fuel moves into cells, and your body regenerates and heals.

The metaphor for this navigated course is the ski slope. No matter what your skill level, you must get down the hill. If the ski run is above your skill level, you may not be only stressed, it can be terrifying. The goal is become an expert at life skills and learn to feel safe a higher percent of the time. Here are the prerequisites.

• Have a working knowledge of The DOC Journey course.
• Understand the natural resistance to change.
• Review the “circle of life” with the “ring of fire.”
• Begin to connect to your vision of what is possible.
• Your healing emanates from feeling safe and creative.
• Constructing your new home (life) is the final focus of the journey. Enjoy!!

Overview

First of all, congratulations for reaching this level. The key to healing is persistence and you have already shown a willingness to fully engage in learning to create and live the life you want. Before you began this journey, that may not have seemed possible. But to be clear, your journey is not about completing a course or believing in David Hanscom. It is about connecting your own capacity to heal. Healing of any part of the body is nothing short of miraculous, but so is the gift of life.

Many people arrive at this point of their journey and they feel better. So, being back to their baseline, they quit. “I am good enough,” and they move on with their life. I think that it is tragic to stop now. Your creative brain is coming alive and the potential for future learning and growth is unlimited. Why would you want to stop?

There are actually a few reasons why this happens so often.

• Humans are programmed by every second of their lives. Our brains unconsciously memorize everything. Familiar patterns are not noticed since not only are they embedded in our brains, but they are our version of reality. Any new or unusual data catches our attention and stimulates some level of threat physiology. We feel anxious and instinctively resist change. So, maybe you are back to a comfortable baseline state. Why would you wish to continue?
• There is a lot of anxiety with success, if you are used to simply trying to survive. When is the shoe going to drop? A classic example is golf. It is remarkably predictable that when you have shot well for three or four holes that your anxiety levels rise. Of course your muscle tension increases, and suddenly it seems like you don’t which end of the club to hold. The same scenario holds true in any performance arena at home, work, or even relaxing.
• Examples are present in every kind of performance. Maybe you have been promoted and have a higher profile in your sphere of influence. More eyes are on you, and many people might jealous of your success. They may look for any opportunity to cut you down. There is a term for this phenomenon called “Tall Poppy Syndrome.” It is easier to just blend in with the crowd.
• Understand that the shoe will always drop. That is life. If your goal is to be in an endless state of bliss, you’ll fail. Life presents an endless number of daily challenges and at some level of stress, your body will respond with threat physiology. Maybe it will last for an hour or even days. It is what your body is supposed to do – protect you. But you now have choices regarding how long you wish to remain there.
• A different problem arises in that now you have tasted what it is like to be in the green center, and you don’t want to leave. Additionally, when you are triggered and in the red, the contrast is sharp and you may get more frustrated about what is possible compared what you are experiencing in the moment. I call this, “the curse of awareness.” What you want to do is nuture emotional flexibilty, be present with whatever state you are in, and move in the direction of your choice.
• I experienced a common scenario in that I had no idea that there were other possibilities about the way I negotiated my life. All I ever knew was anger and chaos. Although, I attended workshops, read self-help books, and underwent extensive counseling. I did not connect with how angry I was until I was 50 years old. It was an incredibly unpleasant experience and I did not have the tools to deal with it. Healing happens with connection – to yourself and then to those around you. Not wanting to experience unpleasant emotions may be a major reason why people don’t engage in this process or pull up short of really moving forward. One of my friends has often quoted the phrase, “you have to feel to heal.”

The ”circle of life” containing the “ring of fire” is the signature tool of this journey. A version of it was created by Dr. Paul Gilbert, who was the founder of compassion-based therapy. Compassion (love) as defined by Anthony DeMello in his book, The Way to Love, is awareness. Anxiety blocks awareness. But as you nurture awareness, you’ll actually feel more anxiety, and it requires tools to tolerate it. This is a bidirectional interaction. So, this final level is focused on not only learning to nurture joy, but also to better tolerate anxiety.

The metaphor is building and decorating a new house. Each room represents an aspect of your life that must be addressed. Use it daily as a quick mental checklist as you go from room to room in your own home. The “lot” is the green center of the circle of life. With repetition, you’ll create the life you want. “To have a good life, you must live a good life.”

Books to read

Art of Living: The Classical Manual on Virtue, Happiness, and Effectiveness

Happiness and freedom begin with a clear understanding of one principle: Some things are within our control, and some things are not. It is only after you have faced up to this fundamental rule and learned to distinguish between what you can and can’t control that inner tranquility and outer effectiveness become possible. The Stoic philosopher Epictetus was born on the eastern edges of the Roman Empire in A.D. 55, but The Art of Living is still perfectly suited for any contemporary self-help or recovery program.

The healing journey progresses from “reaCtive to Creative”. You must first see where you are at before you can change direction. You can’t heal by focusing on problems. Healing occurs with creativity and moving away from unpleasant neurological circuits. The wisdom of the Stoics is remarkable in that it is as, or more, relevant as it was 2000 years ago. Regaining a healthy life perspective is the definitive solution to decreasing your suffering.

On the slopes

A world class skier can ski anything humanly possible if the conditions are reasonable. I used to think I was a double black diamond skier until I was exposed to US Ski Team skiers who were far above a level than I ever imagined. They not only possess a high level of skill, but they are supremely confident as a result of putting in thousands of hours of practice.

Many years ago a group of us where on the back side of mountain at Alta Utah. It was a gorgeus day with a lot of new soft powder. We were all “expert” skiers. We were standing in a narrow line waiting to head down the hill and my son, who is a US Ski team level mogul skier was on another transverse about 30 feet above us. We wondered what he wanted us to do. What he wanted was fresh untracked powder and he took off and jumped over all of us. It must have been a 40-foot drop and he landed about 50 feet down the hill. There was no hesitation. He kept going until the bottom skiing at a high speed. I realized that his was a reality I was not familiar with.

But consider any performance from art, music, dance, athletics, mechanics, business, and work. Every endeavor can be manifested at the highest level. You might be thinking, “I could never accomplish this level of expertise, and in a given field, you probably won’t. Or maybe you already have. However, life skills are accessible to everyone and anyone who wants to commit the living an excellent life. All that is required is a willingness to continue to learn and practice. The DOC Journey presents a foundational set of concepts and tools and there are endless additonal ways to enhance your journey.

The only “goal” of this course is to allow you to connect to the moment you are in and with awareness can be in any color of the “circle of life” on your terms. You have the choice to remain there or move in any direction.

Why not attain the highest level of expertise in living your life? The focus is on attaining skills and not reaching for perfect, where you beat yourself up for “failing.” It is about just learning to execute what you know regardless of the circumstances. Outcomes are usually beyond our control, but you can up the odds of success.

This level is a jumping off point for living the rest of your life. Let yourself think big and enjoy your day.

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• Honor your suffering. You are trapped by physical and mental sensations without an apparent way out.
• You feel extremely isolated but many people in this hole (The Abyss) are also suffering badly. You are not alone.
• Your rightful frustration (rage) fires up your symptoms even more.
• Systematically learning and using tools to calm your body, will allow you to heal.

The Depth of Your Suffering – Darkness

All of us seek safety – physically and mentally. When we don’t feel safe, our bodies switch to a flight or fight mode, and we feel stressed. Another descriptive word is “anxious”, which is simply the feeling generated when you sense danger. We yearn for safety and detest anxiety, and when we can’t resolve the problem causing us to feel uneasy, we feel trapped. The word for this more intense bodily response is anger. It is our last-ditch effort to regain control and feel safe. When we still can’t escape a real or perceived threat, our bodies break down with the outcome being chronic mental and physical diseases.

Anxiety and anger are not psychological constructs; they are your body’s warning signals, and they evolved to be intentionally unpleasant. They are the pain and are manifested in many ways. Even with physical symptoms, the cause is unclear. There are reasons. Chronic stress translates into threat physiology (how your body functions), which causes symptoms, illness, and disease. Unless you know how to effectively process stress, you are trapped.

Feeling trapped causes deep suffering, creates many problems. BTW, everyone suffers. There are degrees, and not having basic needs met such as safety, food, shelter, and companionship creates havoc with every aspect of your health and life. I do not want to dishonor this level of suffering. For example, the incidence of significant anxiety issues is 100% if your income level is less than 19,000/ year.¹ This is 1994 data that translates in approximately $38,000 in 2024.

We are also trapped by being a species with language, abstract thinking, and awareness of the finite nature of life. We can’t escape death. In addition to our physical challenges to staying alive, we cannot escape our thoughts. We have no protection from mental pain and suppressing unpleasant thoughts inflames the brain even more. These translate into RUTs, (repetitive unpleasant thoughts). They are universal varying in severity and frequency. The range is:

• Occasional unwanted thoughts
• Repetitive thoughts
• RUTs
• Repetitive disruptive thoughts
• Invasive thoughts

 “The Abyss”

One afternoon, I was listening to a patient attempting to describe the depth of her suffering and it hit me how deep and hopeless this hole is for most people. I realized that words were inadequate to encapsulate the degree of misery. Since no one seemed to have any answers, there was no apparent way out. The description that seemed to fit for this dark, bottomless pit was “The Abyss”.

A recent research paper documented that the effect of chronic pain on one’s life is similar te the impact of terminal cancer.² You hadn’t anticipated the possibility of your life being consumed by pain. The paper showed that chronic pain was worse in that with cancer, you at least know the diagnosis and there is an endpoint, one way or the other. This statement might sound harsh in that suffering from terminal cancer is horrible, but ongoing pain (mental and physical) without knowing if there is an endpoint is even worse.

A stark example of how uncertainty can eat away at you is illustrated in Dr. Viktor Frankl’s book, Man’s Search for Meaning.³ He was an Austrian psychiatrist who was imprisoned in a concentration camp during WWII. He lost several close family members and experienced unspeakable horrors. As he describes his personal experience, it is difficult to imagine anyone enduring even a fraction of what he witnessed and endured. Yet, he points out that the worst part of it all was not knowing when it was going to end. 

Life in The Abyss

In addition to other life stresses, patients are trapped by unpleasant mental and physical symptoms, illnesses,and diseases. You are also trapped by the medical system, which is not consistently showing you a way out. Over time, you become discouraged (despondent). My equation for it is:

The Abyss = Anxiety/Anger x Time

Why isn’t pain part of this equation? It is because anxiety is the pain. When you are stuck in a whirlpool of relentless anxiety and frustration, life goes dark.

How deep is this hole? Here is a short list of the suffering I have encountered both personally and witnessed in my patients.

Losses include:

• Independence
  • Financial
  • At the mercy of the disability system
• Capacity to enjoy good music, friends, fine food, and hobbies without the experience being marred by pain
• Peaceful family life
• Feeling good – there are over 30 symptoms created by a chronically activated nervous system. There are also many other mental and physical disease states. Your body breaks down.
• Integrity – people don’t believe you and often the harder you try to convince your friends, family, peers, employers, and health care providers, the less you are believed.
  • Being labeled – malingerer, drug-seeker, lazy, not motivated, and difficult
• Unlimited physical activity
• Peace of mind – RUTs are relentless and may be the worst part of the ordeal.
• Hope – this may be the worst aspect of it all. Repeatedly having your hopes dashed induces a depression.

No Way Out

Consider the depth of “The Abyss.” Your soul is being pounded into the ground by a pile driver of anxiety/anger as you remain trapped in your body, riddled by mental and physical pain. Your life is being systematically destroyed, but in some cruel cosmic joke, you’re alive to bear witness – without hope. This dark place in your mind is unusually deep – bottomless. And no one is listening………

Recap

Allow yourself to comprehend the depth of your suffering and degree of damage your pain has inflicted on your life. Awareness is the first step in successfully reversing this downward spiral. Right now, you are at the bottom, except there is no bottom……

Chronic illnesses are complex and random treatments can’t and don’t work. It is necessary to break your unique situation into its component parts and systematically deal with them. There is a way out of this incredibly dark place, but you cannot go from the depths of suffering to better health with willpower and belief. As you methodically acquire knowledge and skills to deal with each aspect of your situation, you’ll be able calm and re-route your body to break free and heal.

Questions and considerations

1. First, give yourself a break. You are suffering badly. Many treatments have failed, and you may even be worse. No one seems to be able to show you a way out or even offer hope. There is no reason to have positive feelings about any of this. Allow yourself to feel the depth of your suffering and frustration. Express it a piece of paper and immediately tear it up. A few people have difficulty processing the feelings released with this exercise, and if you feel uncomfortable, immediately stop.
2. Consider what is important to you in life, but you can’t access or experience them. Write down two or three things you would like to experience. Not being in pain is not one of the choices. You’ll see why as the course unfolds and it is also a given. None of us want to be in pain.
3. List three to five of your most intolerable symptoms. For many people, the relentless onslaught of unpleasant thoughts is the worst aspect of it all.
4. Give yourself credit for staying on your feet long enough to keep trying. A willingness to learn and practice is the number one factor predicting success.

 References:

1. Kessler RC, McGonagle KA, Zhao S, et al. Lifetime and 12-month prevalence of dsm-iii-r psychiatric disorders in the united states: Results from the national comorbidity survey. Arch Gen Psychiatry. 1994; 51(1): 8-9.
2. O’Connor AB. Neuropathic pain: quality-of-life impact, costs, and cost effectiveness of therapy. Pharmacoeconomics (2009); 27: 95- 112.
3. Frankl, Viktor. Man’s Search for Meaning. Beacon Press, Boston, MA, 1959,1962,1984, 2006.

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Here is a famous quote from Gabriel Garcia Marquez.¹

It is not true that people stop pursuing dreams because they grow old.

They grow old because they stop pursuing their dreams.

Gabriel Garcia Marquez

This is a wonderful quote except I have a different take on it.

People grow old because their dreams are crushed by anxiety.

Stress

Stress is the sum total of the obstacles we face every minute to stay alive. When your body is in a flight or fight state, the sensation is called “anxiety.” This reaction is present in every living species, but humans have language and can name it. It is challenging to achieve your dreams and experience the life you wish while feeling stressed. Your creativity and choice are compromised while you are in a survival mode; the blood flow in your brain shifts from the neocortex (thinking centers) to the limbic system (flight or fight).

The Holmes scale², developed in the 1960s, quantifies levels of stress connected with life events, and you can calculate your own cumulative score. A score of 300 points or more correlates to an 80% chance of a health breakdown within 24 months. In spite of overwhelming data connecting chronic stress with illness, disease, and early mortality, we are generally taught that stress and anxiety are “psychological” issues. Nothing could be further from reality. Why does chronic stress cause mental and physical illnesses?

One of my close friends and colleagues were discussing the role of stress leading to health problems and we decided to assess ourselves with Holmes scale. He had been dealing with an unspeakable number of challenges for several years. His score was 435 and then he told me that he had been diagnosed with cancer a few months earlier. Fortunately, he did well with treatment.

Safety

We want to feel safe. In this state our body’s chemistry consists of anti-inflammatory molecules called cytokines. Fuel consumption is lowered (metabolism). There are about 80 billion neurons in your brain that communicate by molecules called neurotransmitters. When feeling safe, these molecules are calming. Hormones include dopamine (reward), serotonin (mood elevator), growth hormone, and oxytocin (social bonding). Emotions represent feelings generated by your physiological state (how the body functions) and safety creates a sense of connection, contentment, and joy. Another term describing this state is “rest and digest.” Your body must refuel, regenerate, and heal in order to sustain life and health.

Threats

What happens when you don’t feel safe? Your body goes into various levels of threat physiology (flight or fight) to optimize survival. It is designed to deal with acute threats effectively and quickly, but it doesn’t do well when your challenges are unrelenting. At the core of all chronic mental and physical disease is being in a sustained stressed state.³ Here is what is going on.

Activated inflammatory cytokines fire up your immune system. In addition to fighting off viruses, bacteria, and other foreign materials, your own tissues are attacked.⁴ Neurotransmitters switch from calming to excitatory and your nervous system is hyperactive. Fuel is consumed from every cell in your body, including your brain. Chronic disease states cause physical shrinkage of your brain.⁵ Fortunately, it regrows as you heal. Stress hormones include adrenaline, noradrenaline, histamines, and vasopressin, which shift your body from thinking to fleeing. This situation can be likened to driving your car down the freeway at 65 mph in second gear. It will break down more quickly than if you are cruising in 5^th gear.

The driving force behind chronic mental and physical disease is sustained exposure to stress physiology. The solution lies in using approaches to increase “cues of safety” and allow your body to rest and regenerate whenever you can.

Dynamic Healing

Sustained stress translates into threat physiology, which creates symptoms. In mainstream medicine, we are just treating symptoms instead of addressing the root cause being the interaction between your stresses and nervous system. We don’t have time to know you, understand the nature of your circumstances, or how we can help you calm down. Treating only symptoms is similar to putting out an oil well fire with a garden hose. It is no wonder that the burden of chronic disease and suffering continues to skyrocket.⁶ In fact, you often feel more stressed while interacting with the medical system. We introduce the concept of “dynamic healing.

Dynamic Healing is a framework that categorizes interventions that decrease exposure to threat and increase safety. The three portals are:

• Input – processing your stresses in a manner to have less impact on your nervous system
• The nervous system – there are ways to lower its reactivity
• The output – directly stimulating your body to go from stress to calming physiology.

This model organizes known research to both clinicians and patients. You can regain control of your care and create a partnership with your provider.

Why not become a “professional” at living life?

Consider the process as becoming a “professional at living life.” It is similar to acquiring any skill such as playing the piano. You must learn the basics, incorporate them into your daily life, and then continue to deepen your expertise with practice. Mastery is critical, and as they become habituated and automatic, life becomes easier to navigate.

Additionally, the power of neuroplasticity (changing your brain) is powerful and unlimited. You can program your brain in whichever direction you wish, away from unpleasant survival circuits.

Modern stresses

Times have changed since 1962 regarding the Holmes-Rahe scale. The industrial revolution occurred only about 200 years ago. In light of over four billion years of evolution, this not even a drop of water in the ocean. The level of daily sensory input dramatically increased. Now we are in the information revolution that began in 1980’s forcing us to process magnitudes more information. Smart phones came online in 2007, and along with the barrage of social media, we are on a massive sensory overload. The human brain has not evolved to keep up with it. So, we have ongoing stress levels that weren’t present even several hundred years ago. It is somewhat perverse that we have so many anxiety-related problems when we have access to more physical comforts than any generation in history. One fallout is that of teen suicide, “deaths of despair”, have risen dramatically correlating with the advent of the bi-directional smart phone.⁷

A healing sequence

The DOC (Direct your Own Care) Journey course teaches skills to optimize your capacity to enjoy life by effectively dealing with adversity and nurturing joy. These are two separate, but linked, skill sets. As you lower your time feeling stressed and increase your sense of safety and joy, your body will regenerate and heal – mentally and physically. Your brain physically changes (neuroplasticity), pleasurable circuits strengthen, and pain (mental and physical) regions atrophy. You can reprogram your brain away from almost anything with persistence and repetition. The exciting aspect of neuroplasticity is that at some tipping point, your healing continues to build on itself and there is no limit as to what life (brain) you wish to create.

What do want out of this life? Decrease your exposure to threat physiology, increase time in safety, enjoy your life, heal, and thrive.

Homework

1. Take the Holmes-Rahe stress assessment test.
2. Write down the details of each category affecting your life.
3. Consider what percent of your time you spend fighting off stresses compared to nurturing joy. Where is your brain developing?
4. The most stressful stresses are the ones you can’t solve. It is why you must learn techniques to minimize their impact, calm your nervous system, and spend less time exposed to threat physiology.
5. What is one aspect of your life that is the most important to you? Write it down. Are you willing to pursue it?
6. Your body is a complex powerful survival machine. It has evolved to seek safety, deal with threats, break loose, and thrive. Allow it to do its job.

 References

1. Gabriel García Márquez. Cien años de soledad (One Hundred Years of Solitude. 1967. Editorial Sudamericanos, S.A., Buenos Aires.
2. Holmes TH, Rahe RH. The Social Readjustment Rating Scale.J Psychosom Res (1967); 11:213–8. doi:1016/0022-3999(67)90010-4
3. Furman D, et al. Chronic Inflammation in the etiology of diseases across the life span. Nature Medicine (2019); 25:1822-1832.
4. Cole SW, et al. Social Regulation of gene expression in human leukocytes. Genome Biology (2007); 8:R189. doi: 10.1186/gb-2007-8-9-r189
5. Seminowicz DA, et al. “Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function.” The Journal of Neuroscience (2011); 31: 7540-7550.
6. Bezruchka S. Increasing Mortality and Declining Health Status in the USA: Where is Public Health?Harvard Health Policy Review [internet]. 2018.
7. Miron O, et al. Suicide rates among adolescents and young adults in the United States, 2000-2017. JAMA (2019); 321: 2362. doi:10.1001/jama.2019.5054 – Connection with cell phones made by Dr. Rob Lustig lecture on 12.1.21 – https://drive.google.com/drive/folders/182pygqTnS2GPQ4LUmioO06zkRf4-jpIH

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There is no reward for being vulnerable for any species of life from one-celled organisms to homo sapiens. Consequences are severe and often swift. It is never safe to be off-guard, and different species create ways to be safe. They need to replenish fuel to fight another day. For example, a dolphin sleeps with one eye open. Many species form protective groups. Consider the number of ways creatures hide or camouflage themselves. Many species simply have thousands of offspring, so a few will survive. When these strategies fail, the final phase is whatever aggressive response they have available to them. The more strength and power, the better.

The added dimension of language

Humans have language, which creates another level of issues around seeking safety. We possess abstract thinking that allows us to engage in the arts, create coordinated societal actions, and have complex relationships with others. We rose to the top of the food chain because of our capacity to cooperate with each other. We have a strong evolutionary need to have close connections and relationships. For example, being socially isolated or lonely has the same effect on your health as smoking 15 cigarettes a day.¹ Look how much effort is put into seeing close friends and family during the holidays. We want to be with each other and the closer the better.

But one of the most perverse aspects of being human, is that successful thriving relationships require vulnerability and trust. These traits are the antithesis of feeling safe. Additionally, emotional/ mental pain is processed in a similar manner as physical pain.² “You hurt my feelings” and You broke my heart” reflect this phenomenon. So, we don’t like pain in any form, yet we have to become vulnerable in order to have deep and satisfying relationships. It is a huge problem, and it is not playing out well for the human race.

By definition, every interaction with another person requires taking a risk of being rejected or hurt. Even checking out at the grocery store involves trusting him or her to accurately document your purchases and help you with your bags. It is nice if they are in a good mood and are friendly. But what if they are having a bad day? Then there are deeper relationships such as being on a team, doing a project together, starting up any type of relationship, and living together. Being rejected at some level of the interaction is not only common, but also the rule. As you become more and more trusting, at some tipping point the level of vulnerability for that relationship will be reached, and one person will pull back or even reject it.

Your options

At this point, your choices are to 1) quit taking risks associated with interacting with others 2) engage but experience social anxiety 3) use whatever power you possess to control others 4) learn to be vulnerable. Since we don’t inherently possess the ability to feel vulnerable, the other less functional strategies are more commonly utilized.

Some form of anger is universal. Why? It keeps you safe. It protects you from both emotional and physical pain. Even if you don’t actually have the power to change the situation, you may feel like you do. Raw anxiety is intolerable and why we hold on to anger.

Why let go of anger?

• The main reason is that you simply cannot heal or thrive when you remain angry. The essence of healing is normalizing your body’s neurochemical state to that of a safety profile, which is profoundly restorative. If your whole system remains fired up, how can that happen? It can’t and won’t.
• Your brain structurally adapts to your focus of attention. You cannot move forward until you let go of the past, especially your deepest wounds. Most people in chronic pain remain angry at the situations or people who have harmed them. The more legitimate your gripe, the harder it is to move on. But how does holding on to the past make your life more enjoyable?
• Anger is destructive, as it is supposed to be. It’s your body’s last ditch effort to escape threat. It is destructive in every direction, including self-destruction. It is the reason why many people completely neglect every aspect of their health. It is tantamount to slow suicide.
• Anger is abusive and destroys relationships. The key element of successful human interactions is awareness of your needs and others’ needs. How else can you constructively interact with those close to you? Anger completely blocks awareness.
• Anger destroys families. Human consciousness evolved through language and social interactions. The ability to cooperate took homo sapiens from the bottom to the top of the food chain. The need for human connection is deep. Unfortunately, close connections are also the strongest triggers. Why would you ever be unkind to someone you care for so much? Why is the incidence of domestic abuse so high? It is maybe the most disturbing paradox of our human existence.
• Anger is the manifestation of the fight mode of the survival response. All organ systems are affected. The blood supply to your gut, bladder, and the frontal lobes of your brain diminishes and is shunted to your heart, lungs, and skeletal muscles. You can’t think clearly, although it might feel like you can. It is critical to, “Take no action in a reaction.”

Interacting with others involves taking the risk of being rejected or even hurt. There are physical risks, such as trusting a business partner who might run off with your money. What about your partner or spouse, who takes off with another person? These are deep ones, but simply reaching out to another person in friendship creates some level of anxiety.

Train your brain

You can use avoidance, suffer from chronic social anxiety, or resort to power and control to feel safe. The healthiest and most satisfying option is learning to be vulnerable and process rejection. In other words, being with anxiety. Being or feeling rejected is inherent to relationships, and unless you understand this, your world will become progressively smaller. Training yourself to lower your threat physiology (anxiety) instead of fighting it allows you to navigate life more easily. BTW, social connections are anti-inflammatory and lower anxiety.³ Addressing social anxiety is a bi-directional process. You can nurture joy, more easily interact with others, feel safer, and create the life you desire.

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References

1. Cigna US Loneliness Index. Cigna: 2018.
2. Eisenberger N. “The neural bases of social pain: Evidence for shared representations with physical pain.” Psychosom Med (2012); 74: 126-135.
3. Dantzer R, et al. Resilience and immunity. Brain, Behavior, and Immunity (2018); 74:28-42.https://doi.org/10.1016/j.bbi.2018.08.010

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• AI and the human brain both are blank slates whose functionality depends on what is loaded into them.
• Your capacity to navigate life depends on the quality of data and the “algorithm” loaded into your brain.
• Poor data or inept processing skills creates ongoing and progressive dysfunctional thoughts and behaviours.
• Your “trauma story” is not a “story”. It is a dynamic state, and you have a choice in directing it.

There is a striking similarity to computer-based learning called artificial intelligence (AI) and the human brain. AI has the capacity to process sensory input, analyze it, and arrive at conclusions as well as make decisions. There is also a marked difference in that AI cannot react to the internal sensations from the body’s physiology (body’s chemistry and function) because there are no neurochemical support systems for AI. Every living creature reacts to its environment through collecting sensory input, analyzing it by the millisecond, and the signals are sent out to regulate the physiology to that of “threat” or “safety.” These internal sensations are called “interoception,” and interpreting these signals is the basis for the evolution of human consciousness.¹

Co-regulate??

Thoughts are a major form of sensory input and emotions are what you feel; they reflect your physiological state (how the body functions). Much of human physiology is regulated through the vagus nerve, which is close proximity with your facial muscles. Through a complex set of interactions, we are able to “co-regulate” with others with the first step being that of determining if the other person is “safe” or not.

AI can only react to electronic signals and can process them without any sense of threat or safety. Even if facial recognition could determine safe or dangerous, there would just be an electronic response that mimicked this state, but there is no chemistry to feel.

AI vs. your brain

The cognitive capacity of AI to accurately analyze vast amounts of data, and arrive at new insights, far outstrips the human brain. It can create art that elicits emotions (physiology) in humans, but another AI machine will be unable to “feel” anything. It also cannot co-regulate with another machine or human, although it may appear that way on the surface. For example, when patients were evaluated by an AI machine compared to physician, the AI machine was much more effective in allowing a patient to feel heard and safe.²  Of course, if a clinician is stressed and feeling rushed, the co-regulation will be in the wrong direction.

But here is the real problem with the human condition that is being highlighted by AI. It is clear that the effectiveness of AI depends on two core factors. The first being the quality of the data being inputted and second that the “rules” of processing the data or the algorithm.

Jinho/AdobeStock

For example, if you simply download the rules of chess into AI without any strategies of how to use it, nothing of significance will happen. For AI to develop a mastery of chess, the data and the approaches need to be “taught” by a chess master. Then it can analyze the approaches, mistakes, good moves, and eventually become a better player than the master.

What if you inputted the wrong rules or if you trained it with someone like me who really only knows the rules and can only see one or two moves ahead. There is little or no chance of the computer gaining enough experience to compete at a high level, much less become a grand master. The computer can improve on good and also enhance incompetence. In the business world, inputting bad data into AI costs industry a lot of money. AI is developing tools and approached to understand when bad data is being gathered and the results are not going in the right direction. Could it salvage my chess game someday? Maybe.

The human database

Let’s get back to the human brain. I often refer to David Eagleman’s book, Livewired, where he clearly describes the incredible neuroplasticity of the human brain.³ It will adapt to almost any input to optimize your chance of survival. But what he describes so well is how dependent we are on our parents for physical survival compared to most mammals. Even more clear is that ALL of our consciousness is constantly programmed every second from birth by sensory input from inside and outside of us. We are who everyone thinks we should be and eventually those “voices” become our own. There are an infinite number of data points and most of it is around molding our “identity”, behaviors, accomplishments, and surviving. Additionally, most of us are not taught effective coping skills and even fewer are taught to nurture joy.

Consider the extreme form of poor input and coping skills of being raised in an abusive environment. All a child needs from his family is to feel safe, be safe, educated, taught relationship skills, and feel nurtured. That’s it. That is not what many of us get. So, the download in our brains from the beginning is “flawed data,” we are not taught to process it, we are too busy surviving to feel safe, and we don’t have the skills to nurture creativity. So, our processing system is full of bad data, analyzed by the wrong set of rules, and our life trajectory may spiral out of control.

OlegD/AdobeStock

The real trauma story

Trauma is stored in your body, but maybe in a different way than you might think. There is a trend to develop a “trauma” story. The real trauma story is reflection of the trend of your entire challenging life. Your “personal AI” will continue to add dimensions and depth to it. You may be rapidly evolving in the wrong direction depending on what “data” has been loaded into it. This is especially true if your “processing system” is also flawed. It is ongoing until you become aware of the nature of the data that is contained in your brain up to this second and you learn more effective methods to process it.

There is good news in that by changing the nature of your input and the way you process it, you can program in any reality you wish. What doesn’t work is trying to rearrange the old data and “fix” the flawed operating system. The first step is becoming aware of the nature (not the details) of the data that has been downloaded into your brain. Equally important is understanding the ways of processing your input to break into these swirling circuits and get your brain moving in the right direction.

To have a good life, you must live a good life. It requires skills and practice.

References

1. Damasio, Antonio. Feeling and Knowing: Making Minds Conscious. Vintage Press, 2022.
2. Ayers JW. 2023. Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum. JAMA Internal Medicine.https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2804309
3. Eagleman, David. Livewired. Canongate Books, 2021.

The post AI and the Cumulative Effects of Trauma first appeared on Back in Control.

The post AI and the Cumulative Effects of Trauma appeared first on Back in Control.

As a surgeon who has spent a lifetime dealing with patients with chronic pain, including me, have come to see that the MUS diagnosis is wholly inaccurate and should be immediately discarded. Every bodily symptom you experience results from an identifiable structural problem or from your body’s physiological response to  your surroundings. Symptoms don’t just happen. The correct diagnosis is MES (Medically Explained Symptoms).

Physiology

Physiology is the term that describes how the body functions. We stay alive because living creatures can maintain an incredibly delicate balance of the body’s acid/ base balance, electrolytes, blood pressure, temperature, heart rate, and the list is long. It is a dynamic process that changes by the second in response to input from your surroundings.

We require safety (rest and relaxation) to regenerate and build up our reserves. When we are under any stress (threat), the body responds with elevated activity in multiple different organ systems to increase the chances of survival. Fuel stores are depleted, and reserves are lowered as energy is shunted to muscles in the event of fast action is required.

Our bodies are intended to be mostly in “neutral” or what is called homeostasis. When you are going about your daily business without noticing how you are feeling, you are in homeostasis. It can be maintained for long periods of time because reserves are being replenished commensurate with your needs.

Any time your body is under any kind of mental or physical threat, your body’s physiology will react in a manner to bring you back into balance. There are three contributors of this scenario 1) your circumstances (input) 2) the state of your nervous system (coping capacity) 3) output (body’s total neurochemical response).

By definition, anytime your senses any level of danger from any source, you are under threat – even if it lasts for just a few seconds. When you are in homeostasis, your body responds so quickly, you won’t notice the changes. However, when the threats begin to overwhelm your nervous system’s coping capacity, you’ll experience unpleasant symptoms.

The threats can be mental or physical and there are almost always multiple physical and mental responses. The physiological manifestations include:

1. Changes in your immune system with increased inflammation.
2. Your body’s metabolism (the rate you burn fuel). You are either storing fuel (anabolic state) or consuming it (catabolic state).
3. Nervous system activity – you are designed to become more sensitized and alert when there is potential danger.

These are broad categories of the effects of threat. But, since there are so many organ systems required to keep you alive, numerous physical and mental symptoms are created. Every symptom that is not from an obvious anatomical problem is a result of this interaction of your body responding to sensory input from your surroundings that is interpreted as potentially dangerous. How else could you stay alive?

Defining threat

Examples of physical threats include viruses, bacteria, being attacked by a predator – human or animal, hunger, lack of shelter, poverty, lack of opportunity, being bullied at work or school, racism, authoritarianism, trapped in a difficult living or family situation, and physical maladies.

Mental threats are processed in a similar manner as physical ones with the same physiological response. (2). They are more problematic in that humans have consciousness and many of our thoughts and emotions are unpleasant, and unlike visible threats like tigers or a severe storm, we cannot escape our thoughts. Repressed thoughts and emotions are even more impactable on your body’s neurochemical state. Many of our unpleasant thoughts are based on cognitive distortions or “stories” about our lives. Unfortunately, whether the threat is real or perceived it has the same deleterious effect.

Physiologically explained symptoms

Unpleasant sensory input progressively impacts your body at three levels.

• Response
• Symptoms
• Illness/ Disease

When the threat is short-lived your response will be appropriate to the situation and quickly disappears when it has passed or resolved. Almost every internal and external action of your body is directing you in a manner, so you don’t feel unpleasant sensations. If you do sense danger, you are programmed to resolve it immediately. Examples are looking away from the sun, spitting out rancid food, pulling your bare foot back from hot pavement, frequently shifting in your chair to avoid skin breakdown, and avoiding an aggressive dog.

When threats are more prolonged, you will begin to suffer symptoms such as back pain, tension headaches, anxiety, poor appetite, nausea, urge to urinate, sexual dysfunction, burning sensations, skin rashes, dizziness, ringing in your ears, and insomnia. There are over 30 different physical symptoms that can occur. (3)

But when threats are sustained, you have a significant chance of becoming seriously ill or developing a disease. It is well-documented that stress kills people and unfortunately the symptoms of a chronic illness also add to the threat load. This is particularly true in chronic pain. (4)

The nature of your body’s physiology under threat

Environmental cues of threat set off a defensive response. Immediately, before you are even aware, your immune system girds for the possibility of injury by initiating inflammation (to protect cells against bacterial or other invasion), elevates metabolism to provide fuel for defense, increases the speed of nerve conduction–which increases your alertness but also your pain sensitivity, and elevates the levels stress hormones (cortisol, adrenaline, noradrenaline, histamines). Much of this defensive state is modulated by small signaling proteins called inflammatory cytokines.

So how do you think you feel when you are in this physiological state? Your heart is racing, you are sweaty, tired, anxious, overwhelmed, nervous, stomach feels tight, blood pressure is elevated, pain is worse, and your breathing is rapid. The bottom line is that you don’t feel great when your body is in this heightened neurochemical state. Are these symptoms imaginary? Not a chance. None of them.

The consequences

This is a list of some of the symptoms and illnesses that are connected with your body’s physiology being in a prolonged heightened state:

Symptoms

• Irritable Bowel syndrome
• Irritable Bladder syndrome (interstitial nephritis)
• Migratory skin rashes
• Tinnitus
• Burning sensations
• Migraine headaches
• Pelvic, neck, thoracic, and low back pain
• Insomnia
• Tendonitis

Illness

• Anxiety
  • Depression
  • OCD
  • Bipolar
  • Schizophrenia
• PTSD
• Fibromyalgia
• Chronic fatigue

Disease

• Autoimmune diseases
  • Colitis/ Crohn’s disease
  • Ankylosing spondylitis
  • Rheumatoid arthritis
  • Multiple Sclerosis
• Cancer
• Coronary artery disease
• Alzheimer’s disease/ Dementia
• Early death
• Suicide
• Addictions
• Parkinson’s disease
• Obesity
• Liver disease
• Osteoporosis

There is a wide range of “Medically Unexplained Symptoms/ Illnesses/ Diseases” that are created by your body’s  survival response. Dr. Stephen Porges has eloquently explained how the autonomic nervous system through the vagus nerve, modulates these various physiological states. (5)

Why is MUS such a deadly diagnosis?

The worst aspect of the diagnosis of MUS is that it creates despair; it takes away hope. Research has shown that hope, optimism, and a sense of purpose are anti-inflammatory and allow your body to regenerate. (6)  So, the diagnosis itself is inflammatory and adds to threat. Do not accept it at any level. The correct diagnosis is MES.

Any major reason MUS is so damaging is that many physicians assume it is untreatable, there is nothing more that can be done, and refer you to a psychologist for any number of reasons that most of you are familiar with. “It is in your head.” You don’t have much of a pain tolerance.” “You are just looking for drugs.” You have “secondary gain issues and don’t really want to work.” The labels keep piling on and none of them are helpful to your healing and they are just wrong. But MUS has a certain finality to it, and it is crushing. It is tragic because physicians have not been taught the link between mental/ physical threats to the physiological changes that cause physical symptoms. I feel the ultimate tragedy is that with the correct understanding, MES is one of the most treatable diagnoses with minimal costs and risks.

Beware of IES (Incorrectly Explained Symptoms)

When there is an obvious anatomical abnormality and the symptoms exactly match the lesion, that would be considered a structural identifiable source of pain. An example would be a painful inflamed tooth. It is a straightforward process to diagnose it by testing with hot and cold or pressure. A root canal or pulling the tool will quickly solve the problem.

But this discussion is complicated by the fact that there is an emphasis in modern medicine to explain reasons for pain from a structural problem when the anatomical abnormality is not actually the cause of it. Many symptoms are attributed to normally aging anatomy and the cause and effect are not supported by medical research.

For example, pain is commonly attributed to scoliosis and there has never been a research paper documenting that it even contributes to back pain unless the deformity is severe and unbalanced (your head is not directly center over your pelvis).

Degenerative disc disease, bone spurs, arthritis, ruptured discs, bulging disc, and spinal arthritis have all been documented in multiple research papers that none of these “diagnoses” are the cause of chronic neck or back pain. (7)

There is marked debate about small tears of the structures around the hip and shoulder. Even severe hip, knee, and shoulder bone-on-bone arthritis has little correlation with pain. There is actually more of a relationsip to stress. (8)

How can you figure this out?

First, it is always important to undergo a medical workup to make sure there is not a structural issue such as vascular disease, pinched nerve, tumor, or an infection.

Second, regardless of the findings of the workup, maintaining your body’s metabolic, immune, and nervous system balance is important. If you require a procedure, your odds of a good outcome will be maximized.

There are many ways to accomplish this. The DOC Journey is one platform that presents proven medical treatments in a way that allows you learn and implement these strategies. All three aspects chronic illness must be addressed.

Output (stimulation of the body’s anti-inflammatory response)

• Breath work
• Mindfulness/ meditation
• Humming
• Vagal stimulation
• Certain pitches of music

State of the nervous system (decreasing sensitivity and stimulating neuroplastic changes in your brain)

• Exercise
• Sleep
• ACT (Acceptance Commitment Therapy)
• Processing prior trauma

Input (what are you uploading into it and what are you holding onto?)

• Forgiveness
• Cognitive Behavioral Therapy
• Expressive writing
• Never discussing your pain or medical care

What really does not work is just “coping”, which is what most of us have been taught to do. It requires specific approaches and tools to effectively create the desired changes. Regardless of what approach you use, the key is to learn how to utilize these tools to consistently process threat in way to keep you in homeostasis or a state of safety.

Finally, you must commit to taking charge of your own body and health. The first step is understanding the nature of chronic disease. The solutions lie in implementing strategies we already know are good for our health–healthy diet, sleep, regular exercise, taking time for yourself, process addictive behaviors, and nurturing close relationships. The common theme with all of these interventions is that they lower inflammation. Ongoing inflammation directly destroys tissues throughout your body.  It sounds daunting but it is more doable than you think. Not taking control may have more severe consequences than you can imagine.

Chronic pain is one of the MUS diagnoses. It is one that is particularly untrue. By understanding the nature of chronic mental/physical pain and the principles behind the solutions, it is a Medically Explained Symptom (MES) and a consistently solvable problem.

MUS must go!

References:

1. Edwards T M, Stern A, Clarke DD, Ivbijaro G, & Kasney LM. (2010). The treatment of patients with medically unexplained symptoms in primary care: A review of the literature. Mental Health and Family Medicine, 7, 209–221.
2. Eisenberger NI, et al. An experimental study of shared sensitivity to physical pain and social rejection. Pain (2006);126:132-138.
3. Schubiner H and M Betzold. Unlearn Your Pain, 3^rdMind Body Publishing, Pleasant Ridge, MI, 2016.
4. Smyth J, et al. Stress and disease: A structural and functional analysis. Social and Personality Psychology Compass (2013);7/4:217-227. 10.1111/spc3.12020
5. Porges Stephen. The Pocket Guide to the Polyvagal Theory: The Transformative Power of Feeling Safe. Norton and Co, New York, NY, 2017.
6. Dantzer R, et al. Resilience and Immunity. Brain Behav Immun (2018);74:28-42. Doi.10.1016.j.bbi2018.08.010
7. Jarvik JG, et al. Three-Year Incidence of Low Back in an Initially Asymptomatic Cohort. Spine (2005); 30:1541-1548.
8. Wise BL, et al. Psychological factors, and their relation to osteoarthritis pain. Osteoarthritis and Cartilage (2010);18:883-887.

The post The Myth of MUS (Medically Unexplained Symptoms) – It’s MES first appeared on Back in Control.

The post The Myth of MUS (Medically Unexplained Symptoms) – It’s MES appeared first on Back in Control.

Chronic mental and physical disease are connected by a common root cause – stress. How and why?

Stress (threat) creates chemical (physiological) changes in your body (fight or flight), which creates mental and physical symptoms. When you are subjected to chronic stress, the ongoing inflammation and increased fuel consumption (metabolism) breaks your body down. Hence, you’ll eventually develop illnesses and disease.

Stress kills

It is well-documented that stress kills. The Holmes-Rahe stress scale was developed in the early 1960’s with points assigned to life events – both positive and negative. If your score was 300 or more, there was an 80% chance of developing a major illness within two years.¹ I have a close friend that I took the test with recently. His score was 463. Guess what? He developed cancer in his spine.

Bruce Lipton is a developmental biologist who stepped out of academic medicine in 1993 because what he was observing in the lab did not conform to the standard thinking in mainstream medicine. He understood that all life is possible because living organisms were able to transform energy into functional forms. Atoms, the building blocks of life and substance consist mostly of space and are powerful energy fields. Biologists embraced the role of quantum physics in biology in 1927, but mainstream medicine has been slow to adapt. His views have not historically been well-received, but it turns out that he was not only right but was decades ahead of his time.

Beliefs and your body

He is the best-selling author of The Biology of Belief. His work is now well-documented regarding the effects that beliefs exert on your body’s physiology. Negative belief systems fire up the fight or flight response and keeps it there. The common link to chronic mental and physical disease is sustained threat physiology and healing happens when you are in safety. Here is a small sampling of some data that supports this perspective.

• Dantzer in 2018² published a review on resilience. He documented the effects of stress on inflammatory molecules called cytokines. There are four factors that lower inflammation.
  • Optimism/ Hope
  • Sense of control
  • Positive outlook/ vision
  • Sense of social connection and community

Notice that when suffering from chronic mental or physical pain that all these factors are compromised – badly.

• Cole in 2007³ documented that chronic stress and social isolation caused the production of aggressive monocytes that he called, “warrior monocytes.” These are white blood cells that attack foreign bodies such as viruses, bacteria, and cancer cells. But these monocytes also attack your own tissues.
• Lisa Feldman-Barrett runs a large neuroscience lab in New England. She has documented that thoughts and consciousness become embedded in our brains as concretely as any object.⁴ So, each person views the world completely differently regarding threats vs safety and body’s coping resources are also infinitely unique. It doesn’t matter if the threat is real or perceived. If your perception of a situation doesn’t match the reality, you’ll have a stress response and your beliefs have to adjust for similar scenarios in the future.
• Note on the Holmes-Rahe stress scale that most of the stresses are not physical. They are real because they are events for which your body has to mobilize resources to deal with them. Unfortunately, perceived stress also causes your body to be activated.
• Consider ACE (Adverse Childhood Events) scores. The score is a rough measure of childhood trauma and higher scores cause inflammatory markers to remain elevated for decades.⁵ When you are raised in an abusive environment, you are programmed to see much of the world as dangerous, and that doesn’t change unless you thoughtfully reprogram your responses.
• Systemic chronic inflammation (SCI) is a state of inflammation that cannot be measured by blood tests.⁶ The problem arises from the breakdown of small structures in each cell called mitochondria. They are the engines whose chemical reactions create the energy of life. The “fuel” leaks outside the cell and is highly inflammatory. Over 50% of all deaths and diseases are caused by SCI. Chronic stress is one of the drivers.
• Pain reprocessing therapy (PRT) is a process where patients’ fears and beliefs about their pain are acknowledged and connected to the actual experience. Patients are reassured that the nature of the pain or problem isn’t dangerous, and then gently taken through a process of reassurance while performing actions that would normally cause pain. By feeling safe while engaging in activities they considered risky, they are able to calm down, feel safe, and the pain decreases or resolves most of the time.⁷ Again, the structure of their body hasn’t changed, it is their beliefs about it.

Why did Bruce and David team up?

It is clear that anxiety and anger are hard-wired automatic reactions that we have not control over. Bruce has pointed out that you might as well have a conversation with the hard drive of your computer. But he has pointed out for a while that you can reprogram them.

I have been on this course of action for a while but have not stated it as clearly as Bruce. I have seen so many “hopeless” patients heal that I am convinced that you can reprogram your brain around almost anything. Our brains are incredibly adaptable.⁸

Getting there

The DOC Journey course and app take you through a sequence that first teaches tools to calm down your nervous system, helps understand the principles of healing chronic disease, presents the problem of anxiety being the pain, explores awareness, teaches anger processing strategies, emphasizes repetition, and then helps you visualize and act on building your future.

The final answer to chronic mental and physical pain is shifting into joy, and where Bruce presents a wonderful picture of what that looks like.⁸ A significant aspect is programming in this outlook. We both agree that positive thinking can’t and doesn’t work. The DOC Journey course and app present practical strategies to achieve the state of consciousness that allows us to not only heal but thrive. Once you flip your beliefs to the future you want, your brain and life will follow, and it will become your reality.

Bruce and I created this four-part video series along with a lesson plan that presents an overview of the healing journey as well as suggestions how to start. We are excited about them in that we did not realize how close we were in our thinking until we made these videos. We hope you enjoy them and welcome to your new life.

References

1. Holmes TH, Rahe RH. The Social Readjustment Rating Scale.J Psychosom Res(1967); 11:213–8. doi:1016/0022-3999(67)90010-4
2. Dantzer R, et al. Resilience and immunity. Brain, Behavior, and Immunity (2018); 74:2842. https://doi.orgl/10/1016/j.bbi.2018.08.010
3. Cole SW, et al. Social Regulation of gene expression in human leukocytes. Genome Biology (2007); 8:R189. doi: 10.1186/gb-2007-8-9-r189

4. Feldman Barrett, Lisa. How Emotions are Made. Houghton Mifflin Harcourt, New York, NY, 2017.
5. Dube, SR, et al. Cumulative childhood stress and autoimmune diseases in adults. Psychosomatic Medicine (2009); 7:243-250.
6. Furman D, et al. Chronic Inflammation in the etiology of diseases across the life span. Nature Medicine (2019); 25:1822-1832.
7. Ashar YK, et al. Effect of pain reprocessing therapy vs placebo and usual care for patients with chronic back pain. JAMA Psychiatry (2021); Published online 9/29/2021.
8. Lipton, Bruce. The Biology of Belief. Hay House, Los Angeles, CA, 2016.

The post Connecting the past and present to the future – Bruce Lipton and David Hanscom first appeared on Back in Control.

The post Connecting the past and present to the future – Bruce Lipton and David Hanscom appeared first on Back in Control.

Objectives

• Providing yourself with cues of safety is essential to healing. However, your body instinctively gravitates towards being aware of threats.
• Even when life is good, your brain is constantly scanning your surroundings (including your consciousness) for danger. It is your “personal brain scanner.”
• As disruptive as anxiety is, it is your protector and gift of life. You are not going to get rid of it or transform it into a pleasant sensation.
• Efficiently dealing with it daily allows you to nurture joy and live the life you wish.

Abraham Maslow was a prominent psychiatrist who looked at the human condition in terms of the hierarchy of needs.¹ At the base of it were basic physiological needs such as food, air, clothes, water, heat , sleep, sexual intercourse, light, hygiene, shelter, urination, and excretion. Without these basics being met, it is unlikely we can or will pursue the higher levels of needs with the top being self-actualization.

What he didn’t mention was that “not being in pain – mental or physical” is not only a foundational need but it is a driving force for most human behavior. People will do almost anything not to feel anxious and vulnerable. It is bi-directional in that lack of the above-mentioned resources will clearly create anxiety and meeting those needs will help lower it. I again want to acknowledge the depth of suffering that occurs in this scenario, and it is almost impossible to pursue a healing journey under severe adversity.

Stress = threat

However, if these needs are being met, then stress (threat) is not the problem. It is the reaction to it that creates so much chaos within you. Avoiding stress doesn’t work and becomes its own stressor. Remember the most impactful stresses are the ones you cannot control. So, that is why learning how to lower your threat physiology through the different portals is so critical.

The metaphor of a bathroom is relevant because you cannot get rid of anxiety and survive. It is part of everyday life. It is important to develop a “working relationship” with it and let it do its work. So, it is a matter of processing life every day, dealing with the waste, and visiting this room as many times as you need to. If your stress reactions build up without an outlet, you will eventually become ill.²

As you learn to develop this relationship with these emotions as opposed to fighting them, you’ll become more skilled in processing them, and your reactions will become fewer and less intense. There are three aspects of lowering this neurochemical inflammatory reaction.

• Separate your identity from this response. It is what you possess, not who you are! It is also universal and there is no reason to take anxiety personally.
• You can directly lower these hormones and inflammatory markers with tools such as humming, breath work, nasal breathing, and calming sounds.
• By stimulating neuroplastic changes in your nervous system, your automatic reactions are less disruptive, and the real healing comes from the creation of new circuits that are pleasurable and creative. There are infinite possibilities and the metaphor of building your new home is a foundational framework.

Emotional flexibility

One solution to dealing with anxiety is control. It is what this sensation is intended to do – be so unpleasant so as to compel you to solve threats – and it works. You are alive and reading this lesson. However, since mental and physical threats are processed in a similar manner, and humans can’t escape their consciousness, we are all trapped by our thoughts to a greater or lesser degree.³ Most of us instinctively fight disruptive thoughts and feelings, but this only reinforces them.

The other strategy, which is actually fairly effective is mental and emotional rigidity. If you train your mind to focus and become immersed in any number of belief systems, your mind is occupied, and unpleasant thoughts are largely “pushed aside.” The beliefs can take any number of different forms such as religion, politics, strong opinions about morality and people who are different than you. What is problematic is that humans are programmed by their own lives and infinitely unique. None of us see anything exactly the same way – even solid objects. Rigid thinking works quite well for decreasing anxiety for the person, but not for those around him or her. You have lost awareness of the needs of others and pigeon-holed them into your way of thinking.

One definitive solution for anxiety is giving up the need for control. In other words, you must learn that anxiety protects you, and is the gift of life. It is also why you have to separate your personal identity from this reaction and develop a “working relationship” with it. It is never going to be a pleasant sensation, but as you become more “emotionally flexible” you’ll learn to tolerate, even become comfortable with it. It needs to be processed daily, all day long.

Emotional perfectionism is a problem. You monitor your progress, feel like you have” failed” if you dive back into being anxious or angry, and your self-critical voices start talking to you. You are now a victim of these thoughts (and you really are), and you are not going to outrun them. Even if you can for a while, they are relentless and will wear you down.

Recap

Anxiety is a physiological state. Glance though the lessons in Leg 3 of this course. It is challenging to deeply change your concepts of anxiety. Most of us are raised to feel that this is a psychological issue and if you are overwhelmed by it, you are not tough enough. “If you can’t take the heat, get out of the kitchen.”

Nothing could be further from the truth. Suppressed anxiety is a disaster, causes damage to the memory center of your brain,⁴ and disrupts every aspect of your life. You are so used to doing it (who taught you otherwise), you may have no idea that this is what you are doing. Being “tough” was at the core of my own descent into The Abyss.

The main focus of The DOC Journey is learning ways to methodically become aware of and process anxiety and anger so you can live a life that reflects who you really are. To have a good life, you have to live a good life. However, this also requires learning how to efficiently separate from and deal with your survival reactions. Being anxious or angry isn’t good or bad. It is life.

 Questions and Considerations

1. Emotional pain hurts. Why would we want to feel that pain? We don’t. However, learning to live with it is essential to healing.
2. Anger effectively covers up feeling vulnerable, which we instinctively dislike. No one EVER wants to give it up, and we can’t. It is another factor in becoming emotionally flexible.
3. It is difficult to understand the necessity of anxiety and anger and also be aware of its impact on you and your life. These emotions preclude awareness and the reason why specific skills are required to break through this catch-22.
4. De-personalize these sensations and develop skills to deal with them. You must let go to move forward.

References

1. Miles Vich. Maslow’s leadership legacy. Journal of Humanistic Psychology (2008); 48: 444–445.
2. Smyth J, et al. Stress and disease: A structural and functional analysis. Social and Personality Psychology Compass (2013); 7:217-227. doi:10.1111/spc.12020
3. Eisenberger NI, et al. An experimental study of shared sensitivity to physical pain and social rejection. Pain (2006); 126:132-138. doi:10.1016/j.pain.2006.06.024.
4. Hulbert JC, et al. Inducing amnesia through systemic suppression. Nature Communications (2015); 7:11003. doi: 10:1038/ncomms11003

The post Processing Anxiety/ Frustration – They are not Going Away first appeared on Back in Control.

The post Processing Anxiety/ Frustration – They are not Going Away appeared first on Back in Control.

• Long term change always occurs in small steps and requires persistence.
• The reason is that our behaviors today are programmed by our entire past life experiences.
• Most of your reactions are automatic, in your subconscious brain, and beyond rational control.
• However, you can reprogram your unconscious by repetition and creating more functional and enjoyable responses.
• Just start.

Many, if most of us, live our lives by endlessly dealing with challenges and then enjoying ourselves when we can. We often don’t have the time or energy to make decisions and choices to experience what we wanted when we graduated from high school. What happened to those dreams?

So, we spend a lot of time reacting to our circumstances instead of creating the life that we want. The problem is that any time you are anxious or frustrated, you are reacting to some unpleasant event from the past that was kicked up by the present. That is how every living creature survives.

We learn what is safe versus threatening and attempt to live our lives in a range that is neutral or safe. It is also well known that avoiding danger is a stronger driving force for behaviors than seeking safety. In addition to avoiding physical danger, humans strive to avoid mental threats, which have the same impact on your nervous system and body. Research has shown that the physiological responses are the same.¹ But since we cannot escape from our thoughts, all of us have some level of a constantly activated nervous system that wears us down. We have discussed many ways de-energize this process.

Then the other part of healing is moving into the part of your brain that experiences pleasure and is safe. It is a process and an acquired skill. Like becoming a virtuoso violinist, it requires repetition to make it a habit. It is again the only way to affect your subconscious brain.

ReaCtive to Creative

If you take the letter “C” out of the middle of the word, “reactive”, you have the word, “creative.” If you can create some space between your stress and reaction, you can substitute a more rational response and with repetition, your brain physically changes (neuroplasticity). A foundational step is the expressive writing, which creates space

Creating structure to organize your life lowers your stresses. You see them more clearly and make better proactive decisions. It also creates some “space” and perspective. If you can’t see all the aspects of a problem, it is harder to solve. Then you can create small behavioral changes that become habitual.

While an important aspect of this journey out of pain is to learn and adopt an organizational system, at the same time it seems overwhelming. So, the first step is to “do something” – anything. You may not have the energy to figure out what you really want at this point. But just get started.

Begin–anywhere

Start small – very small. I presented a template of a personal “business plan” earlier in this leg of the journey. You may have felt that you don’t have the bandwidth to do this or you just can’t do it. Don’t worry about it. Just do something (anything) to start the process. Here are some suggestions and whatever works for you is the key.

• Take piece of paper every morning and write down one optional goal of something you want to accomplish. Just one. It may as simple as staying out of bed for 15 minutes longer than normal.
• Then write down five things you might do to create more order in your life.
• It might resemble your normal to-do list, but it is a more thoughtful set of actions.
• One of the “to do” items could be creating some time for your self-care.
• What routine might you create to center yourself and connect with the day – with or without your pain?

Evolution of the process

 The personal business plan will evolve at some point. As you begin to change your behaviors and heal, your energy will increase.

• Sit down and do a “brain dump.”
• Don’t try to organize it.
• Over time you can begin to “sculpt” and refine it.
• Take time out of the equation. It will only create anxiety–and more pain.
• Try to avoid in making massive changes. You will only become frustrated when you can’t achieve lasting change.

Be kind to yourself

 You will “fail” many times in this process except it is not failure. It’s life. If you look at the Dynamic Healing model, we know that on some days, your stresses are overwhelming, or your nervous system is on high alert from lack of sleep. You will quickly go into flight or fight physiology and not feel great. Your pain usually increases. It is easy to be self-critical in that you were not able to accomplish what you “should” be doing. “Should” thinking is one of David Burn’s ten cognitive distortions² that drains your energy. Simply recognizing the distortion will allow you to let it go and move on.

Whatever you do, get back to the place where you can separate from your self-critical voice (can’t control it), and treat yourself with the respect and compassion that you deserve.

Recap

Since your body’s first responsibility is to keep you alive by being alert for danger, it is the powerful default program of your brain. I refer to this process as having a “personal brain scanner.”

You cannot go from reactive to creative without utilizing repetition to change the subconscious brain. Just having a vague idea of what you want to create is the starting point. Your brain will continue to develop and evolve wherever you place your attention, similar to learning any new skill. The skill you want to acquire is how to live an enjoyable life and it doesn’t happen by continually trying to fix your prior one. Consistently considering what you really want out of life and steadily working towards it  is one of the most critical aspects of breaking loose from the grip of chronic pain. But be nice to yourself when you “fail.”

Questions and considerations

1. Do you ever wonder why it is so difficult to live up to your best intentions? It’s because there is a gross mismatch between your rational brain and powerful subconscious one.
2. Your subconscious brain is the product of a lifetime of programming. Most of us were not provided methods of how to program our nervous system in the direction we desire.
3. Remember that your hopes and dreams are a rational construct that cannot be manifested without embedding implementation tools into your subconscious brain.
4. It is also the reason we can rarely keep New Year’s resolutions. We are mentally taking on a lot without a process to bring them alive.
5. People will sometimes make dramatic and lasting changes in response to a major crisis. You don’t need to wait for that to happen in order to move forward.
6. Take control of your life now with persistent small steps and let your brain evolve in the direction you choose.

References

1. Eisenberger NI, et al. An experimental study of shared sensitivity to physical pain and social rejection. Pain (2006); 126:132-138. doi: 10.1016/j.pain.2006.06.024
2. Burns David. Feeling Good. Harper Collins. New York, NY, 1999.

The post Your Life’s Roadmap – Just Begin Anywhere first appeared on Back in Control.

The post Your Life’s Roadmap – Just Begin Anywhere appeared first on Back in Control.

Threat vs. safety

The essence of the problem of chronic disease, including chronic pain, is being under constant threat and the solution lies in teaching people ways to feel safe. Every successful clinician I know has a remarkable ability and commitment to first establishing a strong relationship with his or her patients. This takes time. Without addressing the root cause of safety vs. threat, treating symptoms has minimal effect.

This is a series of emails from a retired physician who has been involved in The DOC Journey that is based what we learned from our workshops. The sequence is important and is also based on literature-based approaches. Medicine already has the data it needs to solve chronic pain, but it is being systematically overlooked. Many physicians individually do know the data and principles and have a lot of success in helping their patients out of pain. My focus for over 30 years is to simply implement what we already know.

I asked her about sharing her experience with The DOC Journey and sharing these concepts with others. Part of The Journey includes weekly virtual Q&A sessions where we learn more about the healing concepts, share our experiences (except discussing pain or medical care) and provide support for each other.

Terrie’s first email  

If you give me the info you want put out there about The DOC Journey, I will share it on my social media pages. Also, you should be proud of what you have created. I know that I would not have been able to be this calm and productive for the last 3 days (the election) without all you’ve taught me. and just looking at the group dynamics Tuesday and Today shows they all have learned and are applying your techniques too. This is so important right now and I thank you so much.

 Second email

I forgot to mention the most important thing for me personally.

Your techniques and teaching have helped me get through the last 3-4 weeks with minimal anxiety (other than the election and even that was less). Three and a half weeks ago they started a workup for malignancy and so far so good – even though the possibility of multiple myeloma still is out there.

But the key thing is that I have been able to remain calm, acknowledge the anxiety and fear, and then use active meditation, polyvagal breathing/humming, and expressive writing (as well as a few other things) to remain in the present. I’ve had a few days where the thoughts kept coming back no matter what I did. But I persisted, told myself that this was normal and OK, and I just had to keep doing what I could to calm my nervous system down. Eventually those methods worked and my mind would go off onto something else and I felt better.

I have to thank you for getting me through these weeks. As you can imagine my medical mind was working overtime for a while. So, all you’ve done along with the social connection capability has  been a big key – I’m so glad you mentioned that the other day too. 

I don’t want to take up much of your time but just wanted you to know how much I appreciate your helping me get through this.

Thanks again!

Third email

After I received her second email, I asked her if I could share her experience. Here is her reply.

Funny you should ask. I wanted to write you and ask if you needed or wanted a testimonial to support your new evolution of presenting  the DOC concepts? 

In addition to everything else today, I had an EGD (upper GI scope) and colonoscopy to continue the rule out malignancy work up. Everything turned out clean so multiple myeloma is really the only remaining diagnosis to really consider. I hope I didn’t write this whole thing already.  I’d I did I can blame it on the drugs. 

Yesterday was the first time since my PHN (post-herpetic neuralgia) resolved that I had a migraine (they were many times a week before that and often life limiting). But I used every technique I have learned in The DOC Journey and kept it at minimum. As I lay waiting for the procedures I did active meditation, awareness, reprogramming to my internal mind movie, and the polyvagal breathing I’ve learned. I was more calm than ever in my life despite the uncertainty of diagnosis as  well as the election. Amazing. 

Your work has also helped me give up the “need” for an identity as a “doctor” (and a pioneer female Navy doctor, as I helped some women become more accepted), a “Navy high ranking officer”, a “Senior Physician in the Army disability system” and an excellent instructor/ teacher” and even a “published  book author”. I am not saying these to impress you because your career is what I would call IMPRESSIVE and what you’ve done to help people is phenomenal.  

I only put those things out because retiring in June of this year in the midst of the pandemic was one of my major concerns of who and what I would be now. With the help of your work I realized I am me and that’s all that matters. It’s been like shedding and I’ve let go of those other “needed” identities. You have helped me into a happy and pleasure-filled retirement despite all the other “stuff”.  And I thank you. 

Sorry it’s long but if you want to use it I want people to see just how and in what ways or aspects you help people. It’s not just pain, it’s life.  

You also don’t need to use initials or change anything. I would be happy to even be a person they could contact I’d they wanted more info or to know if the program/journey is “worth it.” I would be your spokesperson anytime. My story isn’t as spectacular as the others but you’ve helped me make significant life changes in just 4 months. Best regards, Terrie

Free

Since this series of emails, she has really moved forward and completed a 314-mile walk across the State of Tennessee. She recently participated in an even longer endurance walk. She truly has highlighted the concept that age is just a number.

You do not have to be stuck in chronic pain. At the end of the day, it is a choice. You also don’t have to even believe that you can free yourself. The starting point is actually anchored in disbelief. You have tried everything and nothing has worked? Why would this process be any different? The key is to choose to begin the journey and engage in approaches that will stimulate your brain to change in the direction of your choice (Neuroplasticity), and it will. Each person’s experience is unique.

I am honored to be able to share what I learned from my own journey out of chronic pain in a way that has been helpful to her and many others. However, I disagree with her on one point. Every story is spectacular. I have observed and experienced the depth and darkness of life being trapped in pain. The variables are the different ways people ended up in this hole. However, when a given person figures out his or her own version of climbing out of it, it always borders on unbelievable. The contrast between having no hope to thriving is beyond words. It is always inspiring and what keeps me pushing forward.

The post “Physician, Heal Thyself” – and She Did first appeared on Back in Control.

The post “Physician, Heal Thyself” – and She Did appeared first on Back in Control.